Hearing loss secondary to lumbar puncture

Hearing complaints have been described in patients after lumbar puncture, although other symptoms like headache, nausea, and dizziness can easily obscure hearing disorders. Reduced cerebrospinal fluid pressure after lumbar puncture may explain the origin of this vestibulocochlear dysfunction. Two cases of hearing loss and tinnitus that appeared hours after otherwise uncomplicated diagnostic spinal puncture are reported. The pure tone audiogram showed a 40-50 dB bilateral sensorial hearing loss in the lower frequencies. Hearing recovered and tinnitus disappeared entirely within 7-10 days. Since permanent hearing loss has been reported after diagnostic or therapeutic lumbar puncture, we should be aware of the possibility of this adverse effect.     

Acute spinal subdural hematoma following lumbar puncture

A case of acute spinal subdural hematoma following lumbar puncture in a patient with a normal coagulation profile is reported. Lumbar myelography may be unsuccessful. Other methods of myelography (via cisternal or lateral cervical puncture) to corroborate a block may be made or a laminectomy at the proper clinical level without further studies may be indicated.     

Enhanced stress responsivity of Tourette syndrome patients undergoing lumbar puncture

Since 1990, the creation of a Rehabilitation Center for Vietnamese leprosy patients under the aegis of "Oeuvres Hospitalières Fran?aises de l'Ordre de Malte" is the result of emphasized collaboration between governmental and non-governmental organizations, and between medical and paramedical specialists. This humanitarian action is not "a present home delivery". The end of this action is to set progressively a realist enterprise that depends on preliminary epidemiologic investigations on the spot to analyse means and necessities. Frequency of disabilities (49.6%) and predominance of grades 1 and 2 (83.5%) require aids. The realisation of technology transfer at all medical care levels is necessary. But at the same time, it is essential to build surroundings adapted infrastructure, to equip with effective material giving comfort and security for patients, and even to supply with pharmaceutic drugs in order to continue rehabilitation's activities. In short range, patient's selection and regular control give first objective results.     

Spinal subdural haematoma: an unusual complication of lumbar puncture

A case in which a spinal subdural haematoma obscured the diagnosis of spinal stenosis is described. The haematoma resulted as a complication of the lumbar puncture necessary for the myelogram. No other aetiological factors were found, but it is suggested that this condition may become more frequent as the result of iatrogenic haemostatic defects.     

Psoas abscess secondary to lumbar spondylodiscitis caused by gram negative bacilli

The association between psoas abscess and lumbar spondylodiscitis by Gram negative bacilli represents a rare clinical entity. Sometimes the absence of demonstrative symptoms complicates the diagnostic schema. We report about a 72 year-old woman, without previous known diabetes mellitus, who was admitted because of fever of one week duration and a non-ketotic hyperosmolar coma. A left psoas abscess was identified by abdominal computed tomography (CT). The abscess was in communication with the L1-L2 intervertebral space. Although Escherichia coli was identified as the causing agent and appropriate antibiotic therapy was administered, the resolution of the abscess occurred only after the implantation of a percutaneous catheter guided by CT without additional surgery. Percutaneous drainage as a diagnostic-therapeutic technique has rendered the surgery as the last resort in the treatment of psoas abscess.     

Deafness and vitiligo

Seven cases of congenital deafness and an autosomal recessive pedigree pattern were observed in an inbred kindred. Three of the cases also had vitiligo, and there were 2 other cases of vitiligo in this kindred. The vitiligo also appeared to have an autosomal recessive inheritance pattern.     

Acute cauda equina syndrome secondary to lumbar disc herniation mimicking pure conus medullaris syndrome--case report

Chyluria is a urologic manifestation of a lymphatic system disease abnormality and leads to nutritional deficiency. The case of a patient with chyluria is presented, and the results of lymphoscintigraphy with those of contrast lymphangiography are compared. Lymphoscintigraphy very clearly showed the site of the fistulae and was as precise as lymphangiography. Follow-up lymphoscintigraphy 2 months after therapy revealed no radionuclide accumulation. Lymphoscintigraphy is a useful, noninvasive, safe, and simple technique for the diagnosis and follow-up of chyluria.     

Deafness due to topical neomycin (author's transl)

Today neomycin is almost exclusively given as an ointment in combination with other antibiotics, because of its known oto- and nephrotoxicity. Topical application in high dosage can cause ototoxicity as proved by one patient from this clinic. After laryngectomy and neck dissection for an extensive carcinoma of the epiglottis a 2 X 2 cm dehiscent pyocyaneus infected wound was treated daily with neomycin sulphate solution. A total of 30 gm was given over 3 months during which time the patient became deaf neomycin caused the deafness.     

The effect of pamidronate on lumbar spine bone density and pain in osteoporosis secondary to systemic mastocytosis

Orthotopic liver transplantation (OLT) in patients infected with hepatitis B virus (HBV) is known to be associated with a high recurrence rate and poor prognosis. Interferon treatment in these patients offers little benefit and may lead to further complications. Lamivudine, the (-)enantiomer of 3'-thiacytidine, a 2'3'-dideoxynucleoside, is known to be a potent inhibitor of HBV replication in patients with chronic HBV infection. Three HBV-positive OLT patients were administrated lamivudine, 100 mg x 1 orally, for a period of at least 20 weeks, in an open, compassionate-use basis. All three patients were HBV DNA-negative before OLT. HBV reinfection occurred at a median time of 7 months (range, 6-9 months) after OLT, in spite of adequate immunoprophylaxis. All three patients had high serum transaminase levels (alanine aminotransferase [ALT], 103-324 U/L) and histologic evidence of recurrent HBV infection of the grafted liver, and HBV DNA was evident in the sera of all of them. Six weeks after lamivudine treatment, HBV DNA disappeared from the serum of all patients (detected by hybridization); by the 10th week, HBV DNA was also negative by polymerase chain reaction in two out of three patients. Interestingly, the one patient who was HBV DNA positive by polymerase chain reaction still has mildly elevated ALT levels, whereas the other two patients have normal ALT levels. We also noted that on the 5th week there was a transient elevation of serum ALT levels in two patients. No adverse effects or rejection episodes were noted. In conclusion, lamivudine is a beneficial and well-tolerated therapy in OLT patients with recurrent HBV infection. We are studying the effect of lamivudine in other patients and for a longer period of time.     

Deafness in the Muckle-Wells syndrome

Typical of the syndrome described by Muckle and Wells is a combination of progressive perceptive deafness appearing at various ages in a family, but usually at the same age in the same family, arthralgia, urticarious eruption and renal amyloidosis. The existence of incomplete forms, either without deafness or without renal amyloidosis should be known. This perceptive deafness is very probably due to lesion of the internal ear but the histological characteristics do not seem to be very clear at the present time. Finally, as certain of our observations show, in a few cases, conduction may be impaired, either in isolation, or associated with impairment of perception. Only an analysis of a large number of cases will enable the audiological characteristics of this curious syndrome to be defined.     

The APA and Deafness.

Until the 1960s, people who were Deaf and mentally ill lacked access to psychological treatment. Few mental hospitals and clinics had interpreters available, and few psychologists and mental health professionals had knowledge of sign language. Major court decisions and federal laws have effected change, culminating with the Americans With Disabilities Act of 1990. This legislation gave people who are Deaf the right to equal access to mental health care as well as a host of other opportunities they had been previously denied. New access laws allowed Deaf students to become educated as psychologists, and a number of hearing psychologists who knew sign language entered the field of deafness. These two groups assumed vital roles within the American Psychological Association in addressing the issue of mental health access for people who are Deaf. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Monoradiculopathy of the fifth lumbar nerve root due to lumbar disc herniation between lumbar one and lumbar two vertebrae

Mitochondrial mutations are associated with a wide spectrum of human diseases. A common class of point mutations affects tRNA genes, and mutations in the tRNA-leu(UUR) gene (MTTL1) are the most frequently detected. In earlier studies, we showed that lung carcinoma cybrid cells containing high levels (greater than 95%) of mutated mtDNA from a patient with the pathological nucleotide pair (np) 3243 tRNA-leu(UUR) mutation can remain genotypically stable over time, and exhibit severe defects in mitochondrial respiratory metabolism. From such a cybrid containing 99% mutated mtDNA, we have isolated a spontaneous derivative that retains mutant mtDNA at this level but which has nevertheless reverted to the wild-type phenotype, based on studies of respiration, growth in selective media, mitochondrial protein synthesis and biogenesis of mitochondrial membrane complexes. The cells are heteroplasmic for a novel anticodon mutation in tRNA-leu(CUN) at np 12300, predicted to generate a suppressor tRNA capable of decoding UUR leucine codons. The suppressor mutation represents approximately 10% of the total mtDNA, but was undetectable in a muscle biopsy sample taken from the original patient or in the parental cybrid. These results indicate that the primary biochemical defect in cells with high levels of np 3243 mutated mtDNA is the inability to translate UUR leucine codons.